Abstract

MAINIERI-HIDALGO, José A.; SCHMITZ-GERSTLAUER, Iris  and  MAINIERI-BREEDY, Giovanna. Acalasia: estudio de 27 casos en el Hospital Calderón Guardia. Acta méd. costarric [online]. 2003, vol.45, n.1, pp.25-30. ISSN 0001-6002.

This is a retrospecti ve study of the clinical records of 27 patients diagnosed with achalasia at the Dr. R. A. Calderón Guardia Hospital during a period of eleven years from 1991 to 2001. The ratio was of 0.3 per 100.000 inhabitants which is less than the one found in the literature. This is probably due to the absence of esophageal manometry studies which makes difficult the diagnosis of these patients in early stages or with low or moderate symptoms of the disease. The clinical presentation was similar to that reported by other authors, with a ratio men to women of 1.7 to 1 and an average age of 42 years. The symptoms had an average of 7 years, disphagia being the primary one, present in all cases. This was followed by vomiting, thoracic pain, weight loss and gastroesophageal reflux. The esophagoscopy and esophagogram showed data of advanced achalasia such as esophageal dilatation, retention of alimentary rests, and cardial spasm, wich was easily forced opened with the endoscope. The treatment was only medical (Nifedipine and Isordil) in six patients, dilatations and medical in seven patients, and surgical (esophagomiotomy) in fourteen patients, three of them also had an anti reflux procedure. The patients treated medically and with dilatations continued to be symtomatic. Of the operated ones, there was a patient who required dilatations five and nine years after surgery. Two, who did not have an anti reflux procedure are under treatment for this problem, the rest are asymptomatic without any surgical complications.

Keywords : Acalasia; esófago enfermedades; esofagocardiomiotomía.